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Bortezomib, Doxorubicin, and Dexamethasone in Treating Patients With Multiple Myeloma That Has Relapsed or Not Responded to Treatment
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
Sponsored by: Irish Clinical Oncology Research Group
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00814541
  Purpose

RATIONALE: Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as doxorubicin and dexamethasone, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) together with bortezomib may kill more cancer cells.

PURPOSE: This phase II trial is studying how well giving bortezomib together with doxorubicin and dexamethasone works in treating patients with multiple myeloma that has relapsed or not responded to treatment.


Condition Intervention Phase
Multiple Myeloma and Plasma Cell Neoplasm
Drug: bortezomib
Drug: dexamethasone
Drug: doxorubicin hydrochloride
Phase II

Genetics Home Reference related topics: aceruloplasminemia hemophilia
MedlinePlus related topics: Cancer Multiple Myeloma
Drug Information available for: Doxorubicin Doxorubicin hydrochloride Dexamethasone Dexamethasone acetate Dexamethasone Sodium Phosphate Doxiproct plus Bortezomib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label
Official Title: Phase II Study to Assess the Safety, Efficacy, and Tolerability of Combination Therapy With Velcade (Bortezomib), Doxorubicin, and Dexamethasone (PAD) as Therapy for Patients With Relapsed or Refractory Multiple Myeloma

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Response rate (complete and partial response) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Progression-free survival [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]
  • Compare original response to vincristine, doxorubicin, and dexamethasone with response to bortezomib, doxorubicin hydrochloride, and dexamethasone [ Designated as safety issue: No ]

Estimated Enrollment: 69
Study Start Date: December 2005
Estimated Primary Completion Date: March 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To assess the response (partial and complete response) in patients with relapsed or refractory multiple myeloma receiving bortezomib, doxorubicin hydrochloride, and dexamethasone (PAD) after prior treatment with a maximum of 6 courses of vincristine, doxorubicin, and dexamethasone (VAD) or VAD-like regimen.

Secondary

  • To assess the safety and toxicity of PAD therapy in these patients.
  • To determine the progression-free survival and overall survival of these patients.
  • To compare the original response to VAD with the response obtained with PAD as assessed by percent fall in paraprotein or Bence Jones Protein, lowest level of abnormal protein achieved, and duration of response in these patients.

OUTLINE: This is a multicenter study.

Patients receive bortezomib IV on days 1, 4, 8, and 11 and doxorubicin hydrochloride IV continuously on days 1-4. Patients also receive oral dexamethasone on days 1-4 (and days 8-11 and 15-18 of course 1 only). Treatment repeats every 21 days for 4-6 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 2 months for 1 year.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of multiple myeloma

    • Relapsed or refractory disease
  • Must have received no more than 6 courses of vincristine, doxorubicin hydrochloride, and dexamethasone (VAD) or VAD-like therapy (e.g., VAMP, CVAMP, or Z-Dex)
  • Measurable serum and/or urine paraprotein, or serum free light chain
  • No nonsecretory disease
  • Patients must meet 1 of the following criteria:

    • Received an autologous transplantation in the past year and received no more than 1 prior line of therapy
    • No prior autologous transplantation, achieved ≥ partial response with prior VAD therapy, and received not more than 2 prior lines of therapy
    • Achieved minimal response, no change, or progressive disease with prior VAD therapy, and received ≥ 2 (if no change or progressive disease) or 4 courses (if minimal response) of VAD or VAD-like therapy

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-3
  • Serum bilirubin < 1.5 times upper limit of normal (ULN)
  • Serum ALT and AST < 2.5 times ULN
  • Platelet count ≥ 75,000/mm³
  • Absolute neutrophil count ≥ 1,000/mm³
  • Serum creatinine ≤ 400 μmol/L
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception
  • Peripheral neuropathy or neuropathic pain < grade 2 as defined by NCI CTCAE v. 3.0
  • Cardiac ejection fraction ≥ 40% by ECG or MUGA scan
  • No pericardial disease
  • No acute diffuse infiltrative pulmonary disease
  • No known HIV seropositivity
  • No known hepatitis B or C infection
  • No prior or concurrent malignancies at other sites, except appropriately treated localized epithelial skin or cervical cancer, or other cancer from which patient has been cured and disease-free for more than 5 years
  • No medical or psychiatric condition that, in the opinion of the investigator, contraindicates the patient's participation in this study

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No plasma exchange within the past 21 days
  • No prior bortezomib therapy
  • No more than 1 prior autologous transplantation
  • More than 4 weeks since prior and no concurrent use of any investigational drug
  • No other concurrent antineoplastic therapy, including thalidomide and derivatives
  • No concurrent COX-inhibitors
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00814541

Locations
Ireland
Adelaide and Meath Hospital, Dublin Incorporating the National Children's Hospital Recruiting
Dublin, Ireland, 24
Contact: Helen Enright, MD, FRCPI, FRCPath     353-1-414-3912     helen.enright1@amnch.ie    
Mater Misericordiae University Hospital Recruiting
Dublin, Ireland, 7
Contact: Peter O'Gorman, MD     353-1-803-2000        
Mid-Western Cancer Centre at Mid-Western Regional Hospital Recruiting
Limerick, Ireland, 0009
Contact: Maeve Leahy, MD     353-61-482-900        
St. James's Hospital Recruiting
Dublin, Ireland, 8
Contact: Paul Browne, MD     353-1-410-3756        
St. Vincent's University Hospital Recruiting
Dublin, Ireland, 4
Contact: Donald M. McCarthy, MD     353-1-209-4280     d.mccarthy@st-vincents.ie    
University College Hospital Recruiting
Galway, Ireland
Contact: Mike O'Dwyer, MD     353-91-524-222        
United Kingdom, England
Leeds Cancer Centre at St. James's University Hospital Recruiting
Leeds, England, United Kingdom, LS9 7TF
Contact: Gordon Cook, MD, PhD     44-113-206-7940        
Saint Bartholomew's Hospital Recruiting
London, England, United Kingdom, EC1A 7BE
Contact: Jamie Cavenagh, MD     44-207-601-8202        
University College Hospital Recruiting
London, England, United Kingdom, NW1 2BU
Contact: Kwee Yong, MD     44-845-155-5000        
United Kingdom, Northern Ireland
Belfast City Hospital Trust Incorporating Belvoir Park Hospital Recruiting
Belfast, Northern Ireland, United Kingdom, BT9 7AB
Contact: Curly Morris     44-28-9026-3733        
Sponsors and Collaborators
Irish Clinical Oncology Research Group
Investigators
Principal Investigator: Curly Morris Belfast City Hospital Trust Incorporating Belvoir Park Hospital
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000629438, ICORG-05-01, 2005-000395-41, EU-20893
Study First Received: December 24, 2008
Last Updated: January 7, 2009
ClinicalTrials.gov Identifier: NCT00814541  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
refractory multiple myeloma
stage I multiple myeloma
stage II multiple myeloma
stage III multiple myeloma

Study placed in the following topic categories:
Dexamethasone
Immunoproliferative Disorders
Blood Protein Disorders
Hematologic Diseases
Blood Coagulation Disorders
Bortezomib
Vascular Diseases
Paraproteinemias
Hemostatic Disorders
Doxorubicin
Multiple Myeloma
Hemorrhagic Disorders
Multiple myeloma
Lymphoproliferative Disorders
Dexamethasone acetate
Neoplasms, Plasma Cell

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents, Hormonal
Immune System Diseases
Antineoplastic Agents
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Gastrointestinal Agents
Antiemetics
Enzyme Inhibitors
Antibiotics, Antineoplastic
Hormones
Glucocorticoids
Pharmacologic Actions
Protease Inhibitors
Neoplasms
Autonomic Agents
Therapeutic Uses
Cardiovascular Diseases
Peripheral Nervous System Agents
Central Nervous System Agents

ClinicalTrials.gov processed this record on January 15, 2009